Gun Violence is a Public Health Issue

by Jenny Nguyen

As the second-leading cause of death for persons aged 15–24 in the United States, violence is a complex social disease with physical components. It is spread like an infectious disease following pandemic patterns, has an impact on entire communities, and has the potential to be prevented through the power of strong community networks and social services systems that can change outlooks.

Violence is a fascinating intersection between agency and structural factors — an individual’s circumstances may predispose him or her to being more likely to engage in violent activity, but agency will ultimately determine whether those actions are carried out. Consequently, violence should be included under the umbrella of bioethics. Its various dimensions that touch upon bioethical concerns such as informed consent, health literacy, public health ethics, and research ethics make it more difficult to distinguish between what is wrong or right, necessitating the nuanced principles of bioethics.

Much research supports the idea that violence can be learned and spreads like an infectious disease. It is a public health issue and should be addressed using the principles of bioethics. At its surface level, if we apply the “greatest happiness principle” of utilitarianism, violence is bad and therefore results in the opposite of happiness.

Although the individuals performing the aggressive acts may feel some kind of satisfaction from completing such acts, the suffering of those targeted and their families, even communities, will greatly outweigh the amount of joy that such acts confer on the aggressor.

Albert Bandura showed in his Bobo Doll study that children who observed adults acting aggressively towards a Bobo Doll were more likely to act in physically as well as verbally aggressive ways towards the doll. Different variations of the experiment showed that observing the model being rewarded, punished, or receiving no consequence for beating up the Bobo Doll supported Bandura’s social learning theory, in which people learn through observation, imitation, and modeling, in addition to people learning through the rewards or punishments of behaviorism. Interestingly, the observation of the acts of aggression seemed to have a greater impact on children if the person beating up the Bobo Doll was of the same gender. This has implications for the kinds of interventions that will be most effective, such as the Cure Violence program that harvests the power of social networks by having an ex-felon community member influence those in their shoes to prevent violence before it occurs.

The consequences of violence are heavy and diverse, ranging from increased violence in individuals and future generations of their families to invoking fear in the communities in which the violent acts occur. Not only is violence a consequentialist bioethics issue, it also involves the four principles of principlism — autonomy, beneficence, non-maleficence, and justice. Individuals are capable of making their own decisions, and we want to encourage behaviors that benefit individuals without harming them. From a social justice point of view that promotes solidarity, everyone should have a right to not experiencing violence because it has various detrimental consequences.

As discussed earlier, violence can increase the likelihood of others becoming violent whether it is family members or community members. Looking downstream, this could lead to the children of violent individuals being more likely to be incarcerated, and the negative effects that incurs. However, violence not only impacts development, it also influences social, physical, and mental well-being. People (whether victims or aggressors) can feel withdrawn from society, feel stigmatized, and be bruised (emotionally and physically). Taken together, these greatly decrease one’s quality of life and prevents an individual from becoming a valuable functioning member of society. Taken at a larger scale, this impacts communities’ progress as a whole for further generations.

Following the perspective of deontology, it should be our duty to prevent violence. The consequences of violence are vastly detrimental, and the motives behind acts of aggression are often vengeful and hateful. Furthermore, the second interpretation of Kant’s Categorical Imperative, also known as the “Practical Imperative” states that there are certain ways that we must not treat people no matter how much utility could be produced by treating them in those ways. Although violence could be used in many settings (for revenge, to punish criminals, to teach people lessons, etc.) to further people’s goals, we should never treat humanity simply as a means.

I consider violence to be an issue that should be addressed using bioethics. Everyone should have the right to a safe, nurturing environment that will help them achieve their goals, and bioethics will be key to that. By mining the power of social networks and social learning to engage valuable community members, we could create sustainable programs to prevent violence. Community engagement can be empowering, fostering minds and creating tools to end the cycle of violence as well as the struggles that accompany it. It certainly will not be an easy task, but the benefits would be tremendous and incredibly worthwhile!

Jenny Nguyen is a MD/MA in Urban Bioethics student at the Lewis Katz School of Medicine at Temple University. She graduated from Yale University in 2016 with a degree in Molecular Biophysics and Biochemistry. Jenny is from New York.